Transvenous pacemaker placement: left lateral decubitus position and wireless digital radiography

A patient presented with symptomatic third degree atrioventricular block requiring emergency transvenous pacemaker placement. During the procedure, wireless digital radiographs tracked the position of the pacemaker electrode, which repeatedly missed the target right ventricle. The patient was then r...

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Bibliographic Details
Published in:The American journal of emergency medicine 2018-03, Vol.36 (3), p.467-469
Main Authors: Broder, J.S., Silver, J.M., Fischetti, C.E.
Format: Article
Language:English
Subjects:
Cardiovascular disease
Catheters
Drug dosages
Electrodes
Emergency medical care
Emergency procedures
Heart
Medical instruments
Patient positioning
Radiography
Ventricle
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Description
Summary:A patient presented with symptomatic third degree atrioventricular block requiring emergency transvenous pacemaker placement. During the procedure, wireless digital radiographs tracked the position of the pacemaker electrode, which repeatedly missed the target right ventricle. The patient was then rolled to left lateral decubitus position and the electrode was advanced into the right ventricle, achieving electrical capture, hemodynamic stability, and symptom resolution. We review the published literature on transvenous pacemaker placement and identify two innovations: left lateral decubitus position to facilitate catheter placement and wireless digital radiography for procedure guidance.
ISSN:0735-6757
1532-8171
DOI:10.1016/j.ajem.2017.11.057